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"Non-compliance or client control?" (Fiveash, 1998)

Discussion in 'Other Health News and Research' started by Tom Kindlon, Aug 28, 2013.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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  2. Tom Kindlon

    Tom Kindlon Senior Member

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    Although it hasn't been explored too much in the literature, I think compliance and adherence is important in terms of activity and exercise programmes.

    I discuss this a bit in my paper:

    "Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome"

    Free at: http://iacfsme.org/BULLETINFALL2011/Fall2011KindlonHarmsPaperABSTRACT/tabid/501/Default.aspx

    People with ME/CFS may have come across it in other situations e.g. not continuing taking a drug because of apparent adverse effects.
     
  3. Valentijn

    Valentijn Activity Level: 3

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    A great place to start - CBT/GET practitioners could learn a lot from examining this question. How are they helping us by getting us to answer questionnaires better when objective physical disability doesn't improve at all in the process? Do they really think that's what we want? Or do they even care?
     
  4. Tom Kindlon

    Tom Kindlon Senior Member

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    Unfortunately this study isn't open-access and I can't find a free copy.

    I had this these sorts of issues in mind when I wrote this section in my paper (link above):


     
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  5. Tom Kindlon

    Tom Kindlon Senior Member

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    This issue is closely related to coercion e.g. being forced to do a CBT/Graded Activity/GET programme by an insurance company (for example), or in a hospital.
     
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  6. Tom Kindlon

    Tom Kindlon Senior Member

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    As I mention above, it's only a short article (701 words including references in brackets), and I think is reasonably easy to read but for anyone who doesn't want to read it all, here are some extracts I thought were useful/interesting:


    ---
    ---
    * it was a nursing journal, but nurse could be substituted for any health or medical professional
    ---
    It ends:
     
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  7. Tom Kindlon

    Tom Kindlon Senior Member

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    Incidentally, Barb Fiveash I believe is Dr. Barb Fiveash, author of "From Chronic Fatigue, Fibromyalgia & IBS to Multisystem Dysregulation"
     
  8. user9876

    user9876 Senior Member

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    There is another aspect of compliance/non-compliance that is talked about in different subjects which is around how hard it is to be compliant.

    Give people tasks that are too hard or just too many tasks (compliance budget) and they will fail to comply. The fault then is with those looking to gain compliance (i.e. those designing treatment plans). So my guess is that many patients don't comply with GET if they are told to push past their limits or carry on when they have a relapse. Of course people don't like to admit to being non compliant so therapists may not realise.
     
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  9. Simon

    Simon

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    Monmouth, UK
    Interesting stuff indeed.

    Some more recent developments chime with this (see patient revolution blog)

    And this comes from the BMJ editorial this year "Let the Patient Revolution begin"
    Also relevant are e-patients, empowered patients, typified by 'e-patient Dave' (Dave deBronkart) who said that the idea originated with
    That's actively engaged, but not merely carrying out instructions. e-patient Dave had given a TED talk and penned a recent article for the BMJ, so this is very current.
     
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